Here is what I think about conclusions—one shouldn’t be in a hurry to jump them. In this third post of my four part series on knee pain I’ll explain why conventional wisdom doesn’t tell the whole story on what causes knee pain osteoarthritis. By the end of this post you’ll have a good understanding of how to better prevent knee pain.
What is Knee Pain Osteoarthritis?
This is a common condition and occurs when the cartilage in your knee becomes soft and develops tears in it. The husband of a knee pain sufferer illustrates the point below. He states the following:
“Last year her family physician informed her that she had osteoarthritis in her right knee. By December she was in a lot of pain and her mobility was cut in half. Twice over the next four months from January to April, 2018 she had two sets of x-rays that showed she no longer had cartilage remaining in her knee, which meant that her knee movements were bone on bone and very painful.”—-knee pain forum
What Conventional Wisdom Says About What Causes Knee Pain Osteoarthritis
Conventional wisdom is that osteoarthritis of the knee results mostly from wear and tear, which is why, these days, it’s more common among older people and those whose excess body weight puts extra stress on those joints…
At first glance that’s hard to argue with. It seems quite sensible to assume that as we get older we just wear down our knees. Also, it gets harder to control our weight. This is important when one considers that even a weight loss as small as 5% can drastically improve your knee pain.
Also, there’s some basic information about how a knee can become osteoarthritis that we need to keep in mind before we can challenge the conventional wisdom that such a condition is doomed to never be prevented because weight gain and old age is just part of human maturity.
Here’s Knee Pain osteoarthritis 101
There are two main types of arthritis which can affect your knee joint. The first one is osteoarthritis. This is caused by degeneration of your bones as illustrated by the story above. Your knee joint area has a space between your thigh bone and your shin bone, this space is filled with cartilage and fluids. This creates a smooth surface that allows your knee joint to bend and move in a fluid motion with no pain.
This is The Deal
When this cartilage begins to thin out or wear down the bone underneath begins to protect itself. It does this by becoming thicker and by adding new bone to protect the joint. These new bones are called knee spurs and create a bumpy surface, so your knee will now not move in a smooth fashion.
These knee bone spurs cause bone to rub on bone which causes knee pain and arthritis. These spurs also limit your knee movement and can cause your knee to become stiff.
The second type of arthritis which can develop in your knee joint is rheumatoid arthritis. This type of arthritis is an inflammatory condition which is normally long term and can develop in other areas of your body.
Rheumatoid arthritis causes inflammation and excessive fluid to build up in your joints. In many cases the cartilage often gets destroyed or becomes extremely thin. If you are suffering from this condition your knee joints can be swollen, painful and feel warm. As well you will find your knee movement is severely limited and you experience a lot of stiffness in your knees.
More Bad Knees Today Than Yesterday
Here’s the gist. American doctors have been noticing an increase in osteoarthritis of the knee. The incidence of arthritis has more than doubled for people who were born essentially after World War II. Doctors have suspected “ two driving forces: more old people and more people who are overweight”. However, A study published Proceedings of the National Academy of Sciences contradicts “the view that recent surge in knee osteoarthritis occurred simply because people live longer and are more commonly obese” 
An Unexpected Finding About What Causes Knee osteoarthritis
The study “examined long-term trends in knee OA levels in the United States from prehistoric times through the early industrial era to the modern postindustrial era. These data show that knee OA long existed at low frequencies, but since the mid-20th century, knee OA has approximately doubled in prevalence, even after accounting for the effects of age and BMI” 
In other words, prehistoric Inuit hunter-gatherers from Alaska, for example, suffered less knee pain and had less knee problems than we do. As Daniel Lieberman, a professor of human evolutionary biology at Harvard University states, “Surely all that running around, squatting, twisting and other activity in the days before cars and couches would have worn out joints quickly.” 
He found out that wasn’t the case at all. Those prehistoric guys and girls hunting for food had healthier joints than us. Also, Lieberman notes the trend toward sedentary lifestyles since World War II. This coincided with the double increase in OA cases for those who were born after World War II.
The bottom line is that there must be other factors besides old age and big weight gain that is responsible for a dramatic increase in OA today compared to the past. The emerging census is that a lack of activity may do more to explain the increase in OA than first thought.
By moving you are lubricating your knee joint with its own natural fluid. When you sit still for long time periods this fluid dries out and this is why your knee will feel stiff and sore. The reason why this is a big deal is that it challenges the assumption that knee pain osteoarthritis is insolvable.
Think about it. Exercise helps nutrients diffuse into cartilage in the knee and keep it strong and healthy. This means that even as people age they are not doomed to have bad and painful knees. They can engage in exercises that will strengthen the cartilage. Thus, a change in lifestyle which includes exercise may just be the key to understanding what causes knee pain osteoarthritis.
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4 See Note 1